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[Update ESC-Guideline 2017: Focus on PAD]
Roberto Sansone1, Lucas Busch1, Ralf Langhoff2
1Klinik für Kardiologie, Pneumologie und Angiologie, Universitätsklinikum Düsseldorf, Cardiovascular Research Institute Düsseldorf (CARID).
Deutsche Medizinische Wochenschrift (1946)
|October 5, 2018
Summary
New guidelines for peripheral artery disease (PAD) emphasize multidisciplinary care and updated antithrombotic therapies. Management includes statins and exercise for all patients with lower extremity artery disease.
Area of Science:
- Cardiology
- Vascular Surgery
- Clinical Guidelines
Background:
- Peripheral artery disease (PAD) significantly impacts morbidity, mortality, and quality of life.
- Despite improved awareness, PAD requires enhanced management strategies.
Purpose of the Study:
- To present the updated European Society of Cardiology (ESC) guidelines for PAD management.
- To highlight a collaborative approach between cardiologists and vascular surgeons.
Main Methods:
- Development of new guidelines through multidisciplinary collaboration.
- Inclusion of a new chapter on antithrombotic therapies.
- Proposal of the WIFI classification for wound assessment.
Main Results:
- Symptomatic PAD patients may benefit from clopidogrel over aspirin (Class IIb).
- Antiplatelet therapy is not recommended for asymptomatic PAD (Class III).
- Dual antiplatelet therapy recommended post-intervention; statins and supervised exercise therapy are crucial for all lower extremity artery disease patients.
Conclusions:
- Multidisciplinary management with a "vascular team" is essential for PAD.
- Endovascular approaches are favored for short aortoiliac lesions; bypass or endovascular therapy for infrapopliteal lesions.
- Screening for PAD in patients with coronary artery disease or heart failure is recommended (Class IIb).
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